Adoption Application
Animal(s) you are interested in adopting
Applicant's First Name
Applicant's Last Name
Street Address
City
State
Apartment Number (if applicable)
Zip Code
Phone Number
Email Address
Alternate Phone Number
Date of Birth
Drivers License Number
Have you applied anywhere else for a pet?
No
Yes
If yes, where else have you applied for a pet?
Is this pet for you or someone else?
Myself
Someone else
Do you own other pets at the current time?
No
Yes
If yes, please list their names, breeds, and ages.
Are all of your pets spayed/neutered/fixed?
Yes
No
N/A
How many pets have you owned in the last 5-10 years?
What happened to them?
Are your pets current on their vaccinations?
No
Yes
Have you ever turned your dog or cat into a shelter?
No
Yes
If yes, please explain?
Have you ever had a pet euthanized?
No
Yes
If yes, please explain:
How do you feel about having pets spayed/neutered?
Will you declaw?
No
Yes
Do you have a dog door that allows access to the garage or outside
*
No
Yes
Reason you plan to adopt a pet?
Do you own or rent your home?
Own
Rent
How long have you lived at this address?
Less than one month
1-2 months
3-6 months
6-9 months
9-12 months
1-2 years
3-5 years
6-10 years
10 + years
If you rent, does your landlord and lease allow pets?
Yes
No
Unsure
N/A
Including yourself, how many people live in your household?
Please list the ages & relationship of those who live in your home.
Employment Status
Full-Time
Part-Time
Retired
Work from Home
Stay at Home Parent
Student
Unemployed
Other
If you are employed, what is your current occupation?
Will this pet be living inside, outside, or both?
Inside
Outside
Both
Will the animal spend any time in the garage?
No
Yes
How will you handle destructive behavior?
Will you keep the animal up-to-date on vaccinations?
No
Yes
If no, please explain:
Have you ever been convicted of abuse or neglect of a child or animal?
No
Yes
If yes, please explain:
What would you do with your animal if you had to move?
Are you willing to take responsibility for this animal for the next 10-20 years?
No
Yes
If an accident or tragedy were to occur, do you have an outside backup reference that you provide the name and phone number for?
No
Yes
If no, please explain:
Will you allow us to perform home checks?
No
Yes
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal.
No
Yes